Provider Demographics
NPI:1104472968
Name:ONYIMA, AMARACHI E (LGPC)
Entity type:Individual
Prefix:
First Name:AMARACHI
Middle Name:E
Last Name:ONYIMA
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 RUSSELL AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1451
Mailing Address - Country:US
Mailing Address - Phone:503-866-0667
Mailing Address - Fax:
Practice Address - Street 1:1420 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4779
Practice Address - Country:US
Practice Address - Phone:202-400-7524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00591101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health